Healthy Aging Community Resource - Merle Shapera, MS, RD, CDE, LD

Healthy Aging & Nutrition

Throughout our life stages, our bodies require certain vitamins and minerals in order to function properly. Most of us are guided by the nutritional recommendations of our family physician during the various stages of our lives. "These recommendations should be addressed at different stages of life, and it's probably safe to start thinking about them in your 30s," says Helen Rasmussen, PhD, and Registered Dietitian at the Human Nutrition Research Center on Aging at Tufts University.

My colleague Merle Shapera, who is a registered dietitian, has for over 35 years, helped her patients of various ages change their diet and health behaviors.

My most effective methods of connecting with people have been in group interactions. People learn best from interacting with other people with the same medical issues. Facilitating discussions about what works best and how the changes can positively impact lives, is what motivates people the most towards changing their own behaviors.

Achievements

Managed the Diabetes Education Center at West Suburban Hospital in Oak Park.

Instructed over 3,000 diabetes educators in using state of the art training tools for educating their patients with diabetes.

Trained physicians throughout the Cook County Health and Hospitals System in conducting Diabetes Group Visits.

Author of a weight management curriculum to be used in 18 satellite ANCHOR HMO health centers throughout the Chicago-land area.

Counseled thousands of patients with diabetes on ways to improve their blood sugar, blood pressure and blood cholesterol levels.

Aging brings on many physical changes. Once the body reaches physiologic maturity, the rate of degenerative change exceeds the rate of cell regeneration. However, people age at different rates.

Physiologic Changes Affecting Nutritional Status

Body composition changes as fat replaces muscle, in a process called sarcopenia. Research shows that exercise, particularly weight training, slows down this process. Because of the decrease in lean body mass, basal metabolic rate (BMR) declines about 5% per decade during adulthood. Total caloric needs drop, and lowered protein reserves slow the body's ability to respond to injury or surgery. Body water decreases along with the decline in lean body mass.

Gastrointestinal (GI) changes include a reduction in digestion and absorption. Digestive hormones and enzymes decrease, the intestinal mucosa deteriorates, and the gastric emptying time increases. As a result, two conditions are more likely: pernicious anemia and constipation. Pernicious anemia may result because of hypochlorhydria, which decreases vitamin B12 absorption and affects approximately one third of older Americans. Constipation, despite considerable laxative use among older people, may result from slower GI motility, inadequate fluid intake, or physical inactivity.

Musculoskeletal changes occur. A progressive drop in bone mass starts when people are in their 30s or 40s; this accelerates for women during menopause, making the skeleton more vulnerable to fractures or osteoporosis. Adequate intake of calcium and vitamin D helps to retain bone.

Other organ changes may occur. Insulin secretion is decreased, which can lead to carbohydrate intolerance, and renal function deteriorates in the 40s for some people.

Cardiovascular changes may occur. Reduced sodium intakes become important, as blood pressure increases in women over age 80 (but, interestingly, it declines in older men). Serum cholesterol levels peak for men at age 60 but continue to rise in women until age 70.

Immunocompetence decreases with age. The lower immune function means less ability to fight infections and malignancies. Vitamin E, zinc, and some other supplements may increase immune function.